Association of Serum Electrolyte Levels with the Prevalence of Hypertension in a High Salt Diet Population

Presentation Number: SAT 526
Date of Presentation: April 1st, 2017

Di Wu*1, Yintao Chen2, Haixia Guan2 and Yingxian Sun2
1Medstar Health Research Institute, Washington, DC, 2The First Affiliated Hospital of China Medical University, Shenyang, China



The relationship between serum electrolyte levels and blood pressure is inconsistent in healthy populations and in certain subgroup populations. It is unclear whether this association exists in high salt diet populations, and whether there is an association with the odds of hypertension.


The objective of this study is to determine the prevalence of hypertension in sodium, potassium, chloride, calcium, phosphate and magnesium electrolyte disturbances (ED), and to evaluate the odds of hypertension across serum electrolyte levels in a high salt diet population.


A total of 11,956 out of 14,016 residents aged ≥ 35 years from Liaoning, China participated in the Northeast China Rural Cardiovascular Health Study between January 2012 and August 2013. Population selection and data collection methods were previously reported (1). Participants who had recent history of medication interfering with serum electrolyte levels and/or eGFR < 60 mL/min/1.73m2 were excluded from the analysis. Hypertension was classified into newly-diagnosed (NDH) and pre-existing hypertension (PDH). The prevalence and odds of hypertension in each ED, and odds of hypertension across electrolyte levels were calculated.


The overall prevalence of hypertension was 46.82% in the 10,555 participants (5000 men, 5555 women) included in this study. Hypertension was most frequent in hypercalcemia (63.07%), hypokalemia (62.63%) and hyponatremia (59.65%). Hypercalcemia was the only ED significantly associated with both NDH (OR, 1.51) and PDH (OR, 2.04). In multivariate analysis, serum sodium levels had no significant correlation with hypertension, while serum potassium levels had a U-shaped trend with PDH. The highest chloride quartile had 35.5% lower odds of PDH than the lowest quartile (OR, 0.645). The highest serum calcium quartile had higher odds of NDH (OR, 0.577) and PDH (OR, 1.635) than the lowest quartile, however, highest serum phosphate quartile was only associated with lower odds of NDH (OR, 0.748). The odds of NDH (OR, 0.864) and PDH (OR, 0.768) is lower in the serum magnesium levels above the median.


This is the largest report in the literature evaluating the association of serum electrolyte levels with the odds of hypertension in a high salt diet population. In this population, serum sodium levels were not associated with odds of hypertension; serum calcium levels and its imbalances were significantly associated with odds of hypertension in all analysis. Further prospective studies are needed to evaluate the relationship of chronic serum electrolyte imbalances with the development of hypertension.


Nothing to Disclose: DW, YC, HG, YS